Method and system for intubation

ABSTRACT

An intubation method and system including the insertion of an endotracheal tube into a patient airway, inflating an cuff associated with the endotracheal tube at a location in the patient airway below the vocal cords, monitoring carbon dioxide concentration in the patient airway at a carbon dioxide monitoring location between the cuff and the vocal cords and adjusting inflation of the cuff based at least in part on the monitoring in order that the cuff inflation generally prevents leakage of carbon dioxide past the cuff.

FIELD OF THE INVENTION

The present invention relates to intubation systems and methodologiesgenerally.

BACKGROUND OF THE INVENTION

The following U.S. Patents are believed to represent the state of theart: U.S. Pat. Nos. 6,062,223; 5,937,861; 5,819,723; 5,765,559;5,752,921; 5,582,167; 5,582,166; 5,579,762; 5,067,497; 4,825,862;4,770,170; 4,501,273; 4,305,392; 4,159,722; 3,794,036 & 3,504,676.

SUMMARY OF THE INVENTION

The present invention seeks to provide improvements to intubationsystems and methods.

There is thus provided in accordance with a preferred embodiment of thepresent invention an intubation method including:

-   -   insertion of an endotracheal tube into a patient airway;    -   inflating a cuff associated with the endotracheal tube at a        location in the patient airway below the vocal cords;    -   monitoring carbon dioxide concentration in the patient airway at        a carbon dioxide monitoring location between the cuff and the        vocal cords; and    -   adjusting inflation of the cuff based at least in part on the        monitoring in order that the cuff inflation generally prevents        leakage of carbon dioxide past the cuff.

Preferably, inflation of the cuff is adjusted to provide a minimuminflation pressure, which prevents leakage of carbon dioxide past thecuff.

In accordance with a preferred embodiment of the present invention, themethod also includes suctioning secretions at a suctioning locationbetween the cuff and the vocal cords.

Preferably, the suctioning location is located between the cuff and thecarbon dioxide monitoring location.

In accordance with a preferred embodiment of the present invention,adjusting inflation is performed by medical personnel based oninformation received from the carbon dioxide monitoring. Alternativelyadjusting inflation may be performed automatically based on informationreceived from the carbon dioxide monitoring.

Preferably, the method includes inserting into the patient airway of acarbon dioxide monitoring conduit extending to the carbon dioxidemonitoring location.

Additionally or alternative, the method includes inserting into thepatient airway of a suctioning conduit extending to the suctioninglocation.

The carbon dioxide monitoring conduit may also serve as a suctioningconduit extending to a suctioning location.

In accordance with one embodiment of the present invention, theinsertion of an endotracheal tube into a patient airway includesinsertion of at least one of a carbon dioxide monitoring conduit and asuctioning conduit disposed therewithin.

There is also provided in accordance with a preferred embodiment of thepresent invention an intubation system including:

-   -   an endotracheal tube adapted for insertion into a patient        airway;    -   an inflatable cuff associated with the endotracheal tube and        arranged to be located at a location in the patient airway below        the vocal cords;    -   a carbon dioxide monitor operative to monitor carbon dioxide        concentration in the patient airway at a carbon dioxide        monitoring location between the cuff and the vocal cords; and    -   an inflatable cuff inflator operative for enabling adjustment of        inflation of the cuff based at least in part on an output from        the carbon dioxide monitor in order that the cuff inflation        generally prevents leakage of carbon dioxide past the cuff.

In accordance with one embodiment of the present invention, the inflatorincludes an adaptive inflator, which is operative to inflate the cuff toa minimum inflation pressure, which prevents leakage of carbon dioxidepast the cuff.

Preferably, the system also includes a suctioner operative forsuctioning secretions at a suctioning location between the cuff and thevocal cords.

In accordance with a preferred embodiment of the present invention, thesystem includes at least one of a carbon dioxide monitoring conduitcoupled to the carbon dioxide monitor and extending therefrom to thecarbon dioxide monitoring location and a suctioning conduit extending toa suctioning location.

In accordance with one embodiment of the present invention, the carbondioxide monitoring conduit also serves as the suctioning conduit andalso couples a suctioner operative for suctioning secretions to asuctioning location between the cuff and the vocal cords.

Alternatively a separate suctioning conduit may be provided for couplinga suctioner operative for suctioning secretions to a suctioning locationbetween the cuff and the vocal cords.

At least one or both of the carbon dioxide monitoring conduit and thesuctioning conduct may be located internally of the endotracheal tube.

BRIEF DESCRIPTION OF THE DRAWINGS

The present invention will be understood and appreciated from thefollowing detailed description, taken in conjunction with the drawingsin which:

FIG. 1 is a simplified pictorial illustration of a intubation system andfunctionality constructed and operative in accordance with a preferredembodiment of the present invention, and

FIGS. 2A, 2B, 2C and 2D are simplified diagrammatic illustrations offour alternative embodiments of the system of FIG. 1.

DETAILED DESCRIPTION OF PREFERRED EMBODIMENTS

Reference is now made to FIG. 1, which is a simplified pictorialillustration of an intubation system and functionality constructed andoperative in accordance with a preferred embodiment of the presentinvention.

As seen in FIG. 1, there is preferably provided an intubation system andmethod wherein an endotracheal tube 10 is inserted into a patientairway. An inflatable cuff 12 is preferably associated with theendotracheal tube 10 and arranged to be located at a location in thepatient airway 11 below the vocal cords. Both the endotracheal tube 10and the inflatable cuff 12 may be entirely conventional or alternativelymay be adapted to integrate features of the present invention, asdescribed hereinbelow. The endotracheal tube 10 may be coupled to aventilator (not shown) in a conventional manner and the inflatable cuff12 may be connected to a manually operated or automatically operatedinflation device (not shown), also in a conventional manner.

In accordance with a preferred embodiment of the present invention acarbon dioxide monitor 14 is provided and is operative to monitor carbondioxide concentration in the patient airway 11 at a carbon dioxidemonitoring location 16 between the cuff 12 and the vocal cords.Preferably a carbon dioxide monitoring conduit 18 is provided forcoupling the monitor 14 to the monitoring location 16.

A suctioning device 20 is preferably provided for suctioning secretionsat a suctioning location 22 between the cuff 12 and the vocal cords.

It is a particular feature of the present invention that the carbondioxide monitor 14 provides an accurate indication of adequate sealingof the patient's airway 11 by the inflated cuff 12, thus enablingminimum effective inflation to be provided, thereby to minimize damageto the patient's airway 11. The accurate and minimally invasive sealingof the patient's airway 11 combined with operation of suctioning devicefor removal of secretions at suctioning location 22 upstream of the cuff12 enables infections to be reduced by effectively preventing suchsecretions to enter the airway 11 downstream of the cuff 12. Thiseffective preventing is the result both of highly effective sealing ofthe airway 11 and of removal of such secretions upstream of the cuff 12.It is appreciated that the efficacy of the suction produced bysuctioning device 20 at suctioning location 22 is enhanced by theprovision of highly effecting sealing of the airway at cuff 12.

It is appreciated that in accordance with one embodiment of theinvention, the cuff inflator may operate automatically based on anaccurate output from the carbon dioxide monitor.

Reference is now made to FIGS. 2A, 2B, 2C, 2D are simplifieddiagrammatic illustrations of four alternative embodiments of the systemof FIG. 1. Turning to FIG. 2A, there is seen a first embodiment of theinvention wherein an endotracheal tube 100 is inserted into a patientairway 111 and an inflatable cuff 112, associated therewith and inflatedat a location in the patient airway 111 below the vocal cords. Theendotracheal tube 100 is typically, but need not be, coupled to aventilator 114. Cuff 112 is connected via an inflation conduit 116 to amanually operated or automatically operated cuff inflator 118.

In accordance with a preferred embodiment of the present invention shownin FIG. 2A, a carbon dioxide monitor 120 is coupled via a carbon dioxidemonitor conduit 122, external of the endotracheal tube 100, to a carbondioxide monitoring location 124, between the cuff 112 and the vocalcords. A suctioning device 126 is also coupled to the conduit 122 forsuctioning secretions at a suctioning location, which in this embodimentis identical to the carbon dioxide monitoring location 124.

Turning to FIG. 2B, there is seen a second embodiment of the inventionwherein an endotracheal tube 200 is inserted into a patient airway 211and an inflatable cuff 212, associated therewith and inflated at alocation in the patient airway 211 below the vocal cords. Theendotracheal tube 200 is typically, but need not be, coupled to aventilator 214. Cuff 212 is connected via an inflation conduit 216 to amanually operated or automatically operated cuff inflator 218.

In accordance with a preferred embodiment of the present invention shownin FIG. 2B, a carbon dioxide monitor 220 is coupled via a carbon dioxidemonitor conduit 222, internal of the endotracheal tube 200 to a carbondioxide monitoring location 224, between the cuff 212 and the vocalcords. A suctioning device 226 is also coupled to the conduit 222 forsuctioning secretions at a suctioning location, which in this embodimentis identical to the carbon dioxide monitoring location 224.

Turning to FIG. 2C, there is seen a third embodiment of the inventionwherein an endotracheal tube 300 is inserted into a patient airway 311and an inflatable cuff 312, associated therewith and inflated at alocation in the patient airway 311 below the vocal cords. Theendotracheal tube 300 is typically, but need not be, coupled to aventilator 314. Cuff 312 is connected via an inflation conduit 316 to amanually operated or automatically operated cuff inflator 318.

In accordance with a preferred embodiment of the present invention shownin FIG. 2C, a carbon dioxide monitor 320 is coupled via a carbon dioxidemonitor conduit 322, exterior of the endotracheal tube 300, to a carbondioxide monitoring location 324, between the cuff 312 and the vocalcords.

In this embodiment, a suctioning device 326 is coupled to a separatesuctioning conduit 328, also external of the endotracheal tube 300, forsuctioning secretions at a suctioning location 330, which is preferablyupstream of the carbon dioxide monitoring location 324.

Turning to FIG. 2D, there is seen a fourth embodiment of the inventionwherein an endotracheal tube 400 is inserted into a patient airway 411and an inflatable cuff 412, associated therewith and inflated at alocation in the patient airway 411 below the vocal cords. Theendotracheal tube 400 is typically, but need not be, coupled to aventilator 414. Cuff 412 is connected via an inflation conduit 416 to amanually operated or automatically operated cuff inflator 418.

In accordance with a preferred embodiment of the present invention shownin FIG. 2D, a carbon dioxide monitor 420 is coupled via a carbon dioxidemonitor conduit 422, interior of the endotracheal tube 400, to a carbondioxide monitoring location 424, between the cuff 412 and the vocalcords.

In this embodiment, a suctioning device 426 is coupled to a separatesuctioning conduit 428, also internal of the endotracheal tube 400, forsuctioning secretions at a suctioning location 440, which is preferablyupstream of the carbon dioxide monitoring location 424.

It will be appreciated by persons skilled in the art that the presentinvention is not limited by what has been particularly shown anddescribed hereinabove. Rather the scope of the present inventionincludes both combinations and subcombinations of the various featuresdescribed hereinabove as well as variations and modifications whichwould occur to persons skilled in the art upon reading the specificationand which are not in the prior art.

1. An intubation method comprising: inserting an endotracheal tube intoa patient airway; inflating a cuff associated with the endotracheal tubeat a location in the patient airway below the vocal cords; monitoringcarbon dioxide concentration in the patient airway at a carbon dioxidemonitoring location in the patient airway above the cuff; and adjustinginflation of the cuff based at least in part on said monitoring in orderthat the cuff inflation generally prevents leakage of carbon dioxidepast the cuff.
 2. An intubation method according to claim 1 and whereininflation of the cuff is adjusted to provide a minimum inflationpressure which prevents leakage of carbon dioxide past the cuff.
 3. Anintubation method according to claim 1 and also comprising suctioningsecretions at a suctioning location in the patient airway above thecuff.
 4. An intubation method according to claim 3 and wherein saidsuctioning location is located between the cuff and the carbon dioxidemonitoring location.
 5. An intubation method according to claim 1wherein said adjusting inflation is performed by medical personnel basedon information received from said carbon dioxide monitoring.
 6. Anintubation method according to claim 1 wherein said adjusting inflationis performed automatically based on information received from saidcarbon dioxide monitoring.
 7. An intubation method according to claim 1and also comprising inserting into the patient airway a carbon dioxidemonitoring conduit extending to said carbon dioxide monitoring location.8. An intubation method according to claim 3 and also comprisinginserting into the patient airway a suctioning conduit extending to saidsuctioning location.
 9. An intubation method according to claim 7 andwherein said carbon dioxide monitoring conduit also serves as asuctioning conduit extending to a suctioning location.
 10. An intubationmethod according to claim 1 and wherein said inserting an endotrachealtube into a patient airway includes inserting at least one of a carbondioxide monitoring conduit and a suctioning conduit disposedtherewithin.
 11. An intubation system comprising: an endotracheal tubeadapted for insertion into a patient airway; an inflatable cuffassociated with the endotracheal tube and arranged to be located at alocation in the patient airway below the vocal cords; a carbon dioxidemonitor operative to monitor carbon dioxide concentration in the patientairway at a carbon dioxide monitoring location in the patient airwayabove the cuff; and an inflatable cuff inflator operative for enablingadjustment of inflation of the cuff based at least in part on an outputfrom said carbon dioxide monitor in order that the cuff inflationgenerally prevents leakage of carbon dioxide past the cuff.
 12. Anintubation system according to claim 11 and wherein said inflatorcomprises an adaptive inflator which is operative to inflate said cuffto a minimum inflation pressure which prevents leakage of carbon dioxidepast the cuff.
 13. An intubation system according to claim 11 and alsocomprising a suctioner operative for suctioning secretions at asuctioning location in the patient airway above the cuff.
 14. Anintubation system according to claim 13 and wherein said suctioninglocation is located between the cuff and the carbon dioxide monitoringlocation.
 15. An intubation system according to claim 11 and alsocomprising: a carbon dioxide monitoring conduit coupled to said carbondioxide monitor and extending therefrom to said carbon dioxidemonitoring location.
 16. An intubation system according to claim 15 andwherein said carbon dioxide monitoring conduit also serves as asuctioning conduit and also couples a suctioner operative for suctioningsecretions to a suctioning location in the patient airway above thecuff.
 17. An intubation system according to claim 15 and also comprisinga suctioning conduit which couples a suctioner operative for suctioningsecretions to a suctioning location in the patient airway above thecuff.
 18. An intubation system according to claim 16 and wherein saidsuctioning location is located upstream of said carbon dioxidemonitoring location.
 19. An intubation system according to claim 17 andwherein at least one of said carbon dioxide monitoring conduit and saidsuctioning conduit are located internally of said endotracheal tube. 20.An intubation system according to claim 17 and wherein at least one ofsaid carbon dioxide monitoring conduit and said suctioning conduit arelocated externally of said endotracheal tube.
 21. An intubation systemaccording to claim 17 and wherein both said carbon dioxide monitoringconduit and said suctioning conduit are located internally of saidendotracheal tube.
 22. An intubation system according to claim 17 andwherein both said carbon dioxide monitoring conduit and said suctioningconduit are located externally of said endotracheal tube.